Pathologic changes in the joint appear to result from biomechanical factors and chondrocytes, which influence tissue damage. Several cytokines and growth factors may be responsible for inflammation and cartilage degradation. Data suggests medical mud bath therapy influences cytokines related to osteoarthritis and confirms that mud bath therapy is able to influence chondrocyte activities.
(Bellometti, 1997)

Forty patients with osteoarthritis were used in a placebo-controlled double-blind study. Sixteen anatomically defined trigger points utilized for analgesic effects were examined. Patients were given eight baths over three weeks. After the second and third weeks, the average pain threshold of the sulfur-peat bath group demonstrated a significant improvement compared with the placebo group.
(Pratzel, 1992)

Mud bath therapy decreases cytokines involved in cartilage destruction in osteoarthritis, and increases growth factors that protect cartilage.
(Int J Clin Pharmacol Res & J Investig Med)

Mud packs and sulphur baths improve morning stiffness, patient self-assessment of disease severity, grip strength, and joint swelling and tenderness in patients with psoriatic arthritis.
(Rheumatology lnt. 19(3): 77-82)

Sulfide ooze mud and sodium chloride baths in treating osteoarthrosis patients. Humoral immunity initially affected in patients with osteoarthrosis returns to normal under the influence of a multiple-modality treatment involving application of sulphide moor in combination with sodium chloride baths.
(Vopr Kurortol Fizioter lech Fiz Kult, 1989 Mar-Apr)

Mud bath therapy influences nitric oxide, myeloperoxidase and glutathione peroxidase serum levels in arthritic patients

Nitric oxide (NO) has recently been proposed as an important mediator in inflammatory phases and in loss of cartilage. In inflammatory arthritis NO levels are correlated with disease activity and articular cartilage is able to produce large amounts of NO with the appropriate inducing factors such as cytokines and/or endotoxin. Neutrophils also play an important role in inflammatory reactions and the level of myeloperoxidase, a constituent of neutrophil granules, is related to the intensity of the inflammation.

Because there is evidence that suggests that mud packs influence the main cytokines involved in cartilage damage, we tried to determine whether NO and myeloperoxidase are involved in the mechanisms of action of mud bath treatment. We enrolled 37 subjects and randomly assigned them to two groups: 19 patients underwent mud bath treatment (group A) while 18 patients underwent bath treatment alone.

Blood samples were obtained before and after the treatment cycles to assay serum levels of NO, myeloperoxidase (MPO) and glutathione (GSH)-peroxidase. The results showed a statistically significant decrease in NO and myeloperoxidase serum values in groups A and B, while GSH-peroxidase was not significantly increase in either of the groups; no correlation was found between NO, myeloperoxidase and GSH-peroxidase serum values.

Mud bath treatment can exert beneficial effects on cartilage homeostasis and inflammatory reactions, influencing NO and decreasing myeloperoxidase serum values. The increase in GSH-peroxidase was not correlated with the reduction of other biochemical markers, suggesting that mud bath treatment has different mechanisms of action.

Bellometti S, Poletto M, Gregotti C, Richelmi P, Bertè F.
Int J Clin Pharmacol Res. 2000;20(3-4):69-80.